Title

Carpal tunnel release using the MANOS CTR system: Preliminary results in 52 patients

Document Type

Journal Article

Publication Date

4-1-2012

Journal

Journal of Hand Surgery

Volume

37

Issue

4

DOI

10.1016/j.jhsa.2011.12.033

Keywords

Carpal tunnel release; carpal tunnel syndrome; MANOS; MANOS CTR; minimally invasive surgery

Abstract

Purpose: To describe a carpal tunnel release technique using the MANOS Carpal Tunnel Release device, with preliminary results in 52 patients. Methods: The MANOS Carpal Tunnel Release device is a blade that divides the transverse carpal ligament using wrist and palm skin punctures. The awake patient provides feedback as the surgeon navigates a 2.1-mm-diameter blunt probe across the undersurface of the ligament from a wrist incision with standard disposable nerve stimulator monitoring. The leading tip of the blunt probe is uninsulated and conducts 2 mA. The surgeon converts the blunt insulated probe into an uninsulated blade by advancing a 0.9-mm needle through the palm with a thumb-activated deployment feature. The surgeon saws the ligament through the 2 skin punctures. We used a validated outcome questionnaire to assess postoperative symptoms at 3 months. Results: Symptom severity and functional status scores compare favorably with literature controls for open and endoscopic surgery at 3 months. One patient required reoperation for incomplete release. There were no tendon or nerve injuries. Conclusions: Preliminary results suggest the MANOS Carpal Tunnel Release device to be safe and effective. Type of study/level of evidence: Therapeutic IV. © 2012 American Society for Surgery of the Hand.

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